This holiday season will give us memories that will be with us for years to come. The most challenging part of this holiday will be trying to visit and celebrate with one another in the midst of a global pandemic created by a novel virus. As of November 21st, 2020 there have been 57,775,599 cases of COVID-19 virus reported worldwide with 1,376,404 deaths attributed to this elusive virus. The US has the most cases and deaths worldwide with 11,743,780 cases reported which has led to 252,861 deaths and 800-2000 new deaths recorded each day. To put it in perspective, this year according to the CDC, there have been 29 million cases of the flu (influenza) with 16,000 deaths in the US.
If it’s any consolation, we are fortunate to live in a state with strong leadership and an informed populous who take this virus very seriously. Because of this, the state of Massachusetts currently has one of the lowest infectivity rates in the country. In our state we have had 200,949 cases and 10,469 deaths. In Essex county to date there has been 30,674 cases and 1,414 deaths. Lest we forget that as of November 22 we are in the middle of a surge and we have reached over 3000 cases in Massachusetts in one day. The cold Massachusetts weather has brought us all indoors and we expect to see a further surge.
Knowing these challenges, the boards of health would like to remind those traveling to this state that Massachusetts requires everyone returning or visiting to have a negative test within 72 hours or to quarantine for 14 days. In addition, to insure a safe and healthy holiday season, the department of health and CDC advises limiting visits to people in your own household, keeping six feet between each other when visiting people outside your immediate household, frequent hand washing, and wearing masks when not eating that cover the nose and mouth. This is very important since as much as 70% of the people who carry the virus may never develop symptoms but they have the potential to give it to a loved one who could potentially become deathly ill.
COVID-19 appears to be omnipresent; spreading mostly through droplets generated through the respiratory tract that CDC officials estimate can stay air born and travel up to 6 feet after leaving its host. Hence the 6 feet social distance advisory. While the virus is most commonly spread by air droplets, as with many viruses it can also be transmitted by touching a surface that has the virus. The virus has been known to last from hours to days depending on the surface. Warmer temperatures and exposure to sunlight can disarm the virus and regular cleaning with ordinary soap and water removes the virus from the surface.
So far we have learned a lot about the virus and we are rapidly developing a vaccine and continue to work on developing anti viral medications to treat this disease, but there is a lot we are still learning about this virus which is why we call it a “novel virus”. Anyone born after 1921 has never experienced a pandemic such as this, however, as new as all this feels, COVID-19 is not the first pandemic.
If we step back in history, the first pandemic recorded was in 541 AD and lasted until 549. The Justinian plague derived its name from the byzantine emperor Justinian the first, also known as Justinian the great. Justinian ruled the Byzantine Empire from 527 until 565. The empire covered the eastern portion of Europe, what was left from the Roman Empire. Justinian was an ambitious emperor who invested heavily into roads, architecture and armies in order to return the empire back to its glory days of ancient Rome (make Rome great again?).
The plague was believed to have been imported from Egypt where grain and food from Egypt was traded for metals. More recent research indicates that it might have started in the Tian Shan mountain range bordering China. No secret experimental Chinese biolabs were known to exist back then. Infested rats stowed away on board merchant ships. The microbe responsible for the pandemic was Yersinia pestis which lived inside the fleas that were living on the rats. The microbe is still around today and has also been linked to the bubonic plague (1346-1353) which devastated Europe in the 14th century. When the pandemic hit Constantinople it killed 300,000 residents in one year, at its peak, it took 5000 lives per day. By the end of the pandemic 40 percent of the city died and it left in its wake 25 million deaths throughout Europe. Symptoms would start out as sweats and body aches and within days swollen, painful lymph nodes called buboes would appear on the body leading to severe chills shakes and fever. Then would come the black blisters filled with pus. People at the time thought it was caused by demons, so to prevent the demon from entering people barred their doors and would not even allow family members to enter. People wore identification tags when they left their homes so if someone would succumb to the disease and die suddenly on the streets, they could be identified. According to Procopius, the court historian of the time, bodies piled up so quickly, they couldn’t be buried fast enough. Corpses had to be burned, buried or dropped off at sea only to float back to shore. The Justinian plague killed millions of people, ruined the economy, farmers died and fields went afoul, bakers died, people starved. Construction workers who were needed to build roads and cathedrals died. Road construction and cathedrals were left unfinished. No one escaped the plague’s wrath, even Justinian and members of the court contracted the disease. Justinian himself survived. In spite of it all, Justinian pressed forward to restore the empire back to its former greatness, Procopius wrote that even with the death and devastation of the farming community, Justinian showed no mercy toward the ruined freeholders. Even then he did not refrain from demanding the annual tax from the citizens and their dead neighbor’s intestate.
By the end of the pandemic it is estimated that about half the population of Europe died. Along with the tragedy, many skills were lost and it took hundreds of years to rebuild the devastation the Justinian plague left in its wake. Today thanks to modern medicine, modern technology, our understanding of epidemiology, and our ability to test and contact trace, it is unlikely that we will be seeing a return to anything as devastating as the Justinian plague.
As throughout history, pandemics do burn out and pass. COVID 19 will too. In the meantime, we need to continue to be cautious and safe in order to protect ourselves and our loved ones. So this holiday season, please do have a happy holiday, stay safe, stay positive and test negative.
For further information on safe health practices please visit Massachusetts Department of Health's COVID resources site here.